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Breast MRI for Diagnosis and Staging of Breast Cancer

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Breast Cancer Screening and Diagnosis

Abstract

Breast magnetic resonance imaging (MRI) has been a very fast developing tool for the assessment of breast cancer and quickly moved from research to clinical settings. It is being used to evaluate patients with specific indications and as a screening tool for high-risk patients. The value of breast MRI arises from its very high sensitivity in detecting breast cancer but more importantly from its ability to functionally assess physiological and biochemical properties of breast tissue, thus helping in the management of breast cancer, including the assessment of the extent of disease, the detection of contralateral disease, and the evaluation of treatment response. Response to treatment has been traditionally assessed based on gross tumor size change, a parameter that has been shown to have limitations in the accurate prediction of the treatment response and outcome. MRI offers functional methods to aid treatment response assessment that better reflect the viability of tumor and tumor burden versus just size changes. Understanding the indications for breast MRI, diagnostic criteria utilized to detect and characterize breast cancer, and technical challenges are important in both clinical and research settings. In this chapter we discuss the utilization of breast MRI in breast cancer diagnosis and staging, including the review of patterns of enhancement and principles of pharmacokinetic modeling for dynamic contrast-enhanced MRI, application of diffusion-weighted imaging and MR-guided breast biopsy, as well as review of technical considerations for optimization of image acquisition and assessment of treatment response.

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Authors and Affiliations

  1. Department of Radiology and Radiological Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA

    Riham H. El Khouli MD, PhD

  2. The Russell H. Morgan Department of Radiology and Radiological Sciences, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Traylor Blg, Rm 309, 712 Rutland Avenue, Baltimore, MD, 21205, USA

    Michael A. Jacobs PhD

  3. The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD, 21287, USA

    Katarzyna J. Macura MD, PhD

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  1. Riham H. El Khouli MD, PhD
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  2. Michael A. Jacobs PhD
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  3. Katarzyna J. Macura MD, PhD
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Correspondence to Katarzyna J. Macura MD, PhD .

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Editors and Affiliations

  1. The Woman's Hospital of TexasWomen's Department of Radiology,, Baylor College of Medicine, Centre for Breast Care and MRI., Houston, Texas, USA

    Mahesh K Shetty

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El Khouli, R.H., Jacobs, M.A., Macura, K.J. (2015). Breast MRI for Diagnosis and Staging of Breast Cancer. In: Shetty, M. (eds) Breast Cancer Screening and Diagnosis. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1267-4_9

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